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Background and Purpose: Scedosporium apiospermum complex as a ubiquitous environmental mold is increasingly reported to cause an invasive fungal infection in immunosuppressive hosts. Herein, we present the case of an immunosuppressive 54-year-old man who developed S. apiospermum complex lung infection and pulmonary adenocarcinoma. Case report: The patient had some complaints of dyspnea and cough during a neutropenic episode. The computed tomography (CT) scan of the patient revealed pleural effusion. After culturing the pleural fluid sample, the fungus was identified by microscopic examination and ITS sequencing. In addition, antifungal susceptibility testing was performed using the M38-A2 microdilution method. The minimum inhibitory concentrations of amphotericin B, voriconazole, posaconazole, and caspofungin were obtained as > 64, 0.06, 0.06, and 0.03 μg/mL, respectively. Voriconazole (administered in two doses of 6 mg/kg and a maximum of 250 mg) was preferred for treatment. The patient received antifungal treatment for 2 months; however, he was lost to follow-up. Conclusion: Scedosporium apiospermum complex should be considered a cause of systemic fungal infections in neutropenic patients. Furthermore, the determination of the in vitro antifungal susceptibilities of clinical strains may contribute to the development of therapeutic approaches.

Background and aim Infections caused by Candida species are significantly increasing today, and invasive Candida infections are generally associated with high mortality. Early diagnosis and identification of Candida spp. is important for the determination of antifungal agents that will be used for treatment. The aim of the present study was to provide a better regimen for Candida infections in the future. Materials and methods TheSensititre YeastOne (SYO) method was compared with The Clinical Laboratory Standards Institute (CLSI) reference broth microdilution (BMD) testing method. Endpoints of minimal inhibitory concentrations (MICs) were determined for both methods. Results By using both methods, MIC values of micafungin, caspofungin, voriconazole, and fluconazole were lower than amphotericin B. The values obtained with the SYO method were in high categorical agreement for ecinocandins and amphotericin B. The results of voriconazole and fluconazole were in low categorical agreement. The categorical agreement between the SYO and the BMD results at 24 h was 82.1% for VORI and 98.4% for AMB. Values obtained with SYO method for all antifungal agents were in high essential agreement with the data of the CLSI reference BMD method. The essential agreement between the SYO and the BMD results at 24 h was 94.0% for MFG and 99.0% for AMB. Conclusions The SYO method was ready-to use, so it appeared to be easier and more efficient for Candida isolates.

Bu calismada hastanemizde izole edilen Candida turlerinin iki farkli yontemle antifungal duyarliliklarinin incelenmesi amaclanmistir. Hastanemizde cesitli departmanlardan gelen klinik orneklerden toplam 200 Candida turu izole edildi. Bu turler geleneksel yontem (germ tup olusturma, corn-meal tween 80 besiyerinde mikroskobik gorunum) ve ticari kit API 20C (Biomerieux, France) ile tanimlandi. Bu turlerin flukonazol (FLU), vorikonazol (VORI), amfoterisin B (AMB) antifungal minimum inhibisyon konsantrasyonu (MIK) degerleri Clinical and Laboratory Standards Institute sivi mikrodilusyon ve disk-difuzyon (DD) yontemine gore degerlendirildi. Izole edilen 200 Candida turu; 100 C. albicans, 25 C. glabrata, 7 C. krusei, 43 C. parapsilosis ve 25 C. tropicalis olarak tanimlandi. Butun Candida izolatlari VORI ‘ye karsi duyarli bulundu. Yuksek direnc (%22,5) orani referans mikrodilusyon yontemi ile AMB antifungaline karsi tespit edilidi. Iki yontem arasinda en iyi kategorik oran sirasi ile VORI (%99), FLU (%84,9) ve AMB (%72,5) olarak hesaplandi.Vorikonazol, flukonazole direncli izolatlarda bile in vitro olarak flukonazolden daha iyi aktivite gostermistir. Ek olarak disk difuzyon yontemi VORI icin alternatif antifungal duyarlilik yontemi olarak degerlendirilebilir.

Background/aim: Dermatophytes are the causative agents of dermatophytosis, which is a common disease worldwide that affects the hair, skin, and nails. Dermatophytes comprise more than 40 species in 3 genera: Microsporum, Trichophyton, and Epidermaphyton. In this study, we aimed to determine the effectiveness of seven antifungal agents: amphotericin B, terbinafine, itraconazole, voriconazole, ketoconazole, miconazole, and fluconazole. Materials and methods: A sensitivity study was performed using a microdilution method in accordance with the CLSI M38-A2 standards using isolates of Trichophyton rubrum (n = 55), Microsporum canis (n = 9), and Trichophyton interdigitale (n = 2), which were identified by sequencing the internal transcribed spacer region of the rDNA. Results: According to the results of antifungal sensitivity tests, the geometric mean (GM) minimum inhibitory concentration (MIC) against T. rubrum was 0.10 μg/mL for ketoconazole, 0.20 μg/mL for itraconazole, 0.07 μg/mL for miconazole, 0.48 μg/mL for fluconazole, 2.27 μg/mL for amphotericin B, 0.06 μg/mL for voriconazole, and 0.06 μg/mL for terbinafine. Conclusion: The most effective antifungal drugs were voriconazole and terbinafine, both of which had a GM MIC of 0.06 μg/mL.

Although the frequency of candidal onychomycosis is increasing daily, there is little information in literature about the epidemiology, pathogenesis, and antifungal susceptibility of this dermatological disease. This study aimed to provide information about the epidemiology, pathogenesis, and azole susceptibility of Candida species isolated from patients living in a region with continental climate. After identification of the isolated strains using conventional methods, proteinase and phospholipase activities were determined by a plate method and biofilm-forming ability was determined using the microplate method. Susceptibility of the same species to fluconazole (FLU), voriconazole (VRC), miconazole (MNZ), itraconazole (ITZ), and ketoconazole (KTZ) were determined by microdilution method. The 50 Candida isolates included 23 C. parapsilosis (46%), 13 C. albicans (26%), 4 C. guilliermondii(8%), 4 C.tropicalis (8%), 2 C.krusei(2%), 1 C.lusitaniae (2%), 1 C. sake (2%), and 1 C. kefyr (2%) isolates. The geometric mean (GM) of the minimum inhibitory concentration (MIC) for FLU, KTZ, VRC, MNZ, and ITZ was 0.4 μg/mL, 0.08 μg/mL, 0.08 μg/mL, 0.2 μg/mL, and 0.6 μg/mL, respectively. Proteinase, phospholipase, and biofilm-forming ability were detected in 18%(9/50), 20%(10/50), and 6%(3/50) of the Candida isolates, respectively. We found that the most frequently isolated species is C.parapsilosis. On the basis of the GM values, the most effective azoles are ketoconazole and voriconazole. The isolated Candida species exhibited low phospholipase, proteinase, and biofilm formation activities.

Contains fulltext : 171933.pdf (Publisher’s version ) (Closed access) Investigations of both virulence factors and antifungal susceptibility profiles are crucial for understanding the pathogenesis and prognosis of ophthalmic mycoses. In this study, we investigated the in vitro antifungal susceptibility of amphotericin B (AMB), voriconazole (VRC), and natamycin (NAT) against a set of 50 fungal isolates obtained from patients with ocular mycoses using the Clinical and Laboratory Standards Institute broth microdilution method. In addition, putative virulence factor, such as secretory phospholipases and proteinases, and biofilm formation activity were analyzed. The geometric means (GMs) of the minimum inhibitory concentrations (MICs) of the antifungals across all isolates were the following (in increasing order): VRC (0.70 mug/mL), AMB (0.81 mug/mL), and NAT (1.05 mug/mL). The highest activity against 14 Aspergillus strains was exhibited by VRC (GM MIC: 0.10 mug/mL), followed by AMB and NAT (GM MICs: 0.21 and 0.27 mug/mL), respectively. However, for 12 Fusarium spp., the GM MIC of VRC (2.66) was higher than those of NAT and AMB (GM MICs 1.3 and 0.8 mug/mL, respectively). Proteinase and phospholipase activity were observed in 30 % and 42 % of the isolates, respectively, whereas only 8 % of the isolates were able to produce biofilms. Phospholipase activity was observed in all Fusarium isolates, but not in any of the Aspergillus isolates. In contrast, biofilm-forming capability was detected in 25 % of the Fusarium isolates, but none of the Aspergillus isolates. The differences in the MICs of AMB, VRC, and NAT, biofilm-forming ability and proteinase and phospholipase activities among the isolates were not significant (p > 0.05). Overall, our study suggests no significant correlation between the antifungal susceptibility profiles and virulence attributes of ocular fungal isolates.